Intensive care unit: a significant space for the professor-student relationship

Unidad de Cuidados intensivos: un espacio significativo para la relación profesor-alumno

Abstracts

OBJETIVO: Discorrer sobre a relação entre professor e aluno no espaço de Unidade de Terapia Intensiva (UTI), sob a perspectiva dos docentes. MÉTODOS: Estudo de natureza qualitativa, na modalidade fenomenológica, no qual foram entrevistados seis docentes - três de instituição pública e três de instituição privada que supervisionavam alunos de enfermagem em UTI adulto. RESULTADOS: Do relato dos sujeitos do estudo, emergiram categorias temáticas que possibilitaram a apreensão da essência do fenômeno estudado. No processo de análise, houve desmembramento em duas subcategorias: Uma aproximação e Facilitando o processo de ensino e aprendizagem. CONCLUSÕES: A prática dos estágios de enfermagem em UTI propicia uma inter-relação entre aluno e professor, favorecendo uma proximidade com o outro e uma individualização do ensino, o que contribui de modo significativo, para enriquecer o processo de ensino e aprendizagem e a relação professor-aluno.

Educação superior; Estudantes de Enfermagem; Ensino; Estágio clínico; Unidades de terapia intensiva

ORIGINAL ARTICLES

Intensive care unit: a significant space for the professor-student relationship^*

Unidad de Cuidados intensivos: un espacio significativo para la relación profesor-alumno

Glauteice Freitas Guedes^I; Conceição Vieira da Silva Ohara^II; Gilberto Tadeu Reis da Silva^III

^IMaster in Health Sciences, Professor at Santa Marcelina and AnhembiMorumbi colleges – São Paulo (SP), Brazil

^IIPhD in Nursing. Associate Professor of Paulista School of Nursing, Federal University of São Paulo – UNIFESP – São Paulo (SP), Brazil

^IIIPostdoctoral in Education in Health Sciences, Full Professor, Federal University of Bahia – UFBA – Salvador (BA), Brazil

^{Corresponding Author}

ABSTRACT

OBJECTIVE: To address the relationship between professor and student within the ICU environment, from the perspective of professors.

METHODS: Qualitative study in the phenomenological modality, in which six professors were interviewed – three from a public institution and three from a private institution, they supervised nursing students in an adult ICU.

RESULTS: From the study individuals statements, semantic categories emerged that allowed the learning of the essence of the phenomenon studied. During the analytical process, there was separation into two subcategories: An approximation and facilitating the process of teaching-learning.

CONCLUSIONS: The practice of nursing internships in ICU provides an inter-relationship between student and professor, favoring an approximation with others and a personalization of learning, which significantly contributes to enrich the teaching and learning process and the student-professor relationship.

Keywords: Education, higher; Students, nursing; Teaching; Clinical clerkship; Intensive care units

RESUMEN

OBJETIVO: Discurrir sobre la relación entre profesor y alumno en el espacio de una Unidad de Cuidados Intensivos (UCI), bajo la perspectiva de los docentes.

MÉTODOS: Estudio de naturaleza cualitativa, en la modalidad fenomenológica, en el cual fueron entrevistados seis docentes – tres de una institución pública y tres de una institución privada que supervisaban alumnos de enfermería en una UCI adulto.

RESULTADOS: Del relato de los sujetos del estudio, emergieron categorías temáticas que posibilitaron la aprehensión de la esencia del fenómeno estudiado. En el proceso de análisis, hubo desmembramiento en dos subcategorías: Una aproximación y Facilitando el proceso de enseñanza y aprendizaje.

CONCLUSIONES: La práctica de enfermería en las UCIs propicia una interrelación entre el alumno y el profesor, favoreciendo una proximidad con el otro y una individualización de la enseñanza, lo que contribuye de modo significativo, para enriquecer el proceso de enseñanza y aprendizaje y la relación profesor-alumno.

Descriptores: Educación superior; Estudiantes de Enfermería; Enseñanza; Prácticas clínicas; Unidades de cuidados intensivos

INTRODUCTION

The teaching-learning process is complex and it can be influenced by many aspects. With the intention of making it more effective, it has been the subject of several studies from different perspectives and in light of different references.

Accordingly, this article originated from the concerns of one of the authors, in the condition of nursing professor from an undergraduate course in Nursing, on the process of teaching-learningin the discipline of Nursing in Intensive Care. It is part of a dissertation⁽¹⁾, from which categoriesemerged. In this article, we will present oneof these categories, called: "A meeting between professors and students," and its subsequent subcategories: An approximationand facilitating the process of teaching-learning.

We understand that the teaching-learning process is an important part of some elements as the professor, the student, the content and the learning environment that, when articulated and interrelated, promote improvement in the quality of teaching⁽²⁾. Among these elements, we highlight two by relevance: professor and student, and the fact that the relationship between them is an essential part of this process.

The proximity between professor-student enables mutual growth, encouraging students to present their ideas clearly and freely, without worrying about the possible judgment by the professor⁽³⁾. This relationship may create opportunities for the professor to assess the theoretical and practical performance of the student in a less stressful manner. Therefore, we may consider that itsignificantly contributes to the success of theteaching-learning process. Given these considerations, reflecting on the teaching activities in the Intensive Care Unit (ICU) by the nursing faculty, understanding them, is an important action, allowing the professora differentiated preparation and follow-up of nursing students, as well as assisting the professor in the construction of the subject teaching plan.

The nature of these activities refers to the care of mankind in very vulnerable situations, involving degrees of dependency, whether for food, hygiene, handling and maintenance of vital functions. Moreover, the space of an intensive care unit is part of fear, high technology, invasive procedures. Finally, a world where the struggle between life and death polarizes itself, making it a feeling of fullness.

All these aspects can affect people who work in the ICU environment, especially students who are beginners. For them, this may be a fruitful area for the genesis of an attitude of respect and regard for men to be cared for, besides that it enables them to acquire knowledge and technical skills.

In this context, the professor-student relationship is of great importance as the nature of this relationship may be decisive for the qualification of professionals with vast expertise and human posture. Thus, it seems important to us to pay close attention on the analysis of this relationship, if well conducted, may constitute a productive meeting for vocational training. Thereby, the objective of this study was to address the relationship between professor and student within the ICU environment, from the perspective of professors.

METHODS

This is a qualitative research – phenomenological modality, whose basis proposal was based on the understanding of what one wants to study while human phenomenon. The research subjects were professors from two educational institutions of Undergraduate Nursing courses, being three professors of a public institution and three professors from a private institution, who supervise nursing internships in adult ICU.

Six interviews were conducted in the period between September 2006 and March 2007, using the following question: "How do you experience the teaching-learning process in internships at the ICU?" Following the philosophical assumptions of the adopted methodology, this number was not pre-determined and thus they were closed when there was theoretical saturation. The interviews took place after review and approval of the Ethics Committee of the FederalUniversity of São Paulo/ São Paulo Hospital – Approval No. 0004/07, and Santa Marcelina College – Approval No. 248/06. Preceding each one, the Consent form was read, ensuring the ethical and legal issues involved in research with humans, thus respecting ethical legal aspects recommended by Resolution 196/96 of the National Health Council. Each interview was recorded with their permission and subsequently transcribed in full by the researcher.

After transcriptions of discourses collected, a qualitative analysis of the phenomenon was performed, which occurred in four stages: a) the researcher read the description in order to have a global idea of discourses in which were enumerated and coded with the letter D; b) the researcher read the description again, more slowly now, enumerating and identifying units of meaning encoded by the following US abbreviation; c) after obtaining units of meaning, the researcher went through all units identified and expressed the meaning contained in there d) the researcher summarized the units of meaning to build thematic categories that have led to the structure of the phenomenon, ie, at its essence, allowing the phenomenon to be unveiled.

RESULTS

The identified thematic categories made the apprehension of the essence of this phenomenon possible and, in the process of analysis, they were split into two subcategories: An approximationand Facilitating the process of teaching-learning.

In the first subcategory – Anapproximation- professors reported in their discourses, the "being with the student" in the development of this process. For them, this "proximity" enables them toprovide students with all the learning they may need, creating a conducive to learning environment. Here are some statements:

... we are very close to students ... (D4US16)

... We get very close to student, we are very present, we give students a sense of safety, also, at the same time, we really try to let them participate during care, he/shetakes responsibility, the student takes responsibility for the critical ill patient... (D4US17)

In intensive care, we always privilege small groups to facilitate closer proximity between professor and student, so he/she can be helped by the professor in all his/her needs, because when an undergraduate student comes into the intensive care, the amount of new equipment and devices is too much, then, he/she must have a professor who is able to provide students with all they need, so that this environment can be a favorable place for learning. (D6US3)

In the second subcategory, called "Facilitating the process of teaching-learning", it is evidenced that the professor facilitates the targeting of this process, as emotional and affective aspects and dynamics of expressions in practical activities of the internship are factors involved in this relationship.

For professors, the proximity of this natural care space allows them to meet the learning needs of students. Here are some statements:

... we facilitate their work, his/her integration in the team ... (D6US8) ... Always

the professor being a facilitator in the field ... (D6US10)

then we facilitate that contact with themultiprofessionalteam ... (D6US13)

In the professors` discourses, we canobserve the professor as being the professional that promotes student learning process, as they interact with the unitmultiprofessionalteam, which provides student interaction with themultiprofessional team in discussions and resolutions of problems of hospitalized patients, facilitating students` understanding in practice.

DISCUSSION

The results allowed us to observe that professors feel responsible for creating a favorable environment to student learning, due to their attitude, their role as an educator, their relationship with students and professional influence which favor or not student learning. They need to handle delicate situations, which generates extreme anxiety and stress, usually present in the ICU world in order to instill confidence, security and serenity in future professionals. Thus, strategies to support and monitor practical activities, conveying to student safety during the process of appropriation of a very specific and complex technology, open discussion of problems, conflicts and inclusion of students in interrelation with other professionals to promote self-confidence, self-esteem and hence the good performance of the student in the learning process. These student support strategies have been recommended in literature⁽⁴⁾.

It may also be noted that professors consider important to allow the student to participate, in a supervised manner, of an effective care, taking care of seriously ill patients. In this sense, to articulate theory and practice, the role of the professionals responsible for overseeing and guiding the training of nurses should be performed by an integration between theoretical and practical knowledge and directed activities, which should provide strategies to approach multiprofessionalteams aiming interaction among peers in the hospital setting⁽⁵⁾.

This relationship fosters interaction between student and professor, which is very prominent in the discourse of professors. It is in these moments of interaction, shared and lived together moments, that the affective domain joins the cognitive sphere and the student gives himself/herself entirely, acting not only with reason, with logical reasoning, but also moved by feelings and emotions from the affective sphere⁽⁶⁾.

The statements highlight that a close relationship between professors and students is essential within the space of an intensive care unit in order to facilitate the process of teaching and care, enabling moreconfidence to students.

Affective and emotional aspects, the dynamics of the expressions in the practical activities of the internship, as well as any form of communication are factors involved in this relationship. The discourses of professors showed that over the nursing internship of intensive care, the relationship between professor and student is strengthened because the professor teaches them, conveying not only scientific-technical knowledge, but also learning contents from their personal and professional life experiences; students also learn how people think and act in different ways, awakening to a more critical awareness and facilitating the teaching-learning process.

Professors also pointed out the relationship with the student both in the classroom and in internships; this engaging and meaningful way of relating with someone, which wecan call solicitude, relates to primary characteristics of being patient and being considerate about another human being⁽⁷⁾. Thus, teaching, a facet of the essence of education, involves solicitude. Some discourses show this attitude towards students.

In human relationships, there is a web of facts, values, beliefs, feelings, perceptions, actions and reactions that often can lead to conflicting situations that challenge students and professors. The professor plays a very important role at this moment, because he/she can reduce such conflicts by being opened for dialogue, respecting the point of view of students and teaching them how to respect the opinions of others⁽⁸⁾. This allows a closeness between the involved and may awaken the student's motivation to learn and draw upon themselves the responsibility to learn. In this context, the area of ​​teaching-learning becomes fruitful to achieve the objectives of the activity, ieinternships at the ICU.

Another aspect that should be considered is that the activities carried out in internships allow a closer relationship between the professor and student when compared to lectures, as there are a smaller number of students under the charge of each professor. In this context, the figure of the professor becomes more present, which contributes significantly to improving teaching-learning⁽⁹⁾.

The learning success lies mainly on affection, trust, empathy and respect between professors and students, students and students, professors and professors⁽¹⁰⁾. Such factors may positively influence the process⁽¹¹⁾, making the professor a facilitator. Being a facilitator professor is not an easy task, paradigms must be shifted.

The relationship between educator and student encourages and activate student interest, so the professor has two basic functions in relation to the student: to encourage and to advise⁽⁴⁾. Thus, during internships, the relationship between professor and student is considered as something positive and present, enabling the professor to understand him/her as a being in the world and the other world in an intensive care unit. Carvalho⁽¹²⁾ emphasizes the importance of professor`s attention to interaction, being close to students, emphasizing a more affective and open relation. In such a relationship, it can be seen more interest from students, because they pay attention to what the professor says and they also effectively participate in studies and in performed work. This is mainly due to this proximity to the professor.

A study investigating interpersonal relationships and academic participation of students shows that students refer to the role of the professor in interactional and behavioral terms, as an important factor in their participation in educational activities⁽⁸⁾. In this subcategory, one can observe that professors recognize the great importance that interpersonal relationships have in the process of teaching-learning.

FINAL CONSIDERATIONS

The presented category allows us to observe that professors consider themselvesfacilitator professionals of the student learning process, because they interact with members of the multiprofessionalteam of the unit, which, in turn, provides the interaction of student and multiprofessionalteam in discussions and resolutions of problems of hospitalized patients, facilitating student understanding in practice. Being close to the students during the development of specific skills of the ICU, also contribute to the identification of nursing problems and resolutions with the multiprofessionalteam.

The practice of nursing internships at the intensive care favors an interrelationship between the student and professor, creating a situation of closeness with others and a singularity of teaching. The professor is likely to act in accordance with the activities, needs and potential of each student. This requires recognition of their role as educators need to transcend the technicality, being aware that the professor-student relationship is critical to the achievement of the objectives proposed in the teaching-learning process.

In the world of an ICU, setting of great human dramas, where the polarity Life-Death is very present, the professor-student relationship may be a relevant factor for a kind of qualification that, besides the technical-scientific skills, should be marked as a humanized care, with care and concern for each other.

In this respect, the present study, despite the fact it does not allow us generalizations because of the number of professors and the nature of the methodology adopted in the study, we alert to the importance of the relationship between professor and student in this scenario as decisive aspect in the process of training of future professionals. It is intended that the results of this study, which show the importance of the relationship between professor and student in the ICU environment, promote reflection and improvement of aspects that may favor it in order to allow improved quality of care.

Received article 03/07/2012 and accepted 14/08/2012

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*

Part of the results extracted from the Master's Thesis presented at the Federal University of São Paulo, entitled: Process of teaching-learning in critical care nursing, in 2008.

Publication Dates

• Publication in this collection
  04 Mar 2013
• Date of issue
  2012

History

• Received
  03 July 2012
• Accepted
  14 Aug 2012